Useful info about how I have solved lower ITB pain?

I am mainly a lurker on these forums, rather than a poster, but can't help but notice just how many posts there are on this particular forum about a) knee problems b) itb problems. Having finally (touches wood) resolved a knee pain that has prevented me from running for the past 10 months, I thought the details of my rehab programme could be useful to some, if not to many!

The issue:

Up until April last year, I was training for a 40km/1800m+ offroad race and regularly doing runs of 10-25kms. However, 10 months ago, when running downhill, I suddenly experienced a sharp,stabbing pain on the outside of my right knee, just above the patella. It forced me to walk. The pain subsided, so I tried to run again. Nope, too much pain. Since then, the pain recurred every time I tried to run. Weird thing was, I could walk up and down hills no problem. But runing downhill and even repetitive running on a level route brought on the pain

The diagnosis;

I had an MRI - nothing to see in the area that was giving me the pain. All normal. I noticed that my right foot turned out when I ran rather than tracking straight. Something was puling it out of line. But what? I did my own research on the internet and found some *very* useful information. This page in particular started me on the road to recovery;

http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/

The rehab routine;

I learnt about the body's kinetics, what muscles are connected to what. I learnt about opposing muscles and what happens when particular muscles are not doing the job they are supposed to do. Most importantly, I learnt about gluteal amnesia and discovered that my right glute med was not as strong as it should be and was not 'firing' correctly. The past month has consisted of;

- exercises to strengthen my gluteus medius muscles (the clam, single leg bridge etc)

- exercises to strengthen my VMO (the muscle that runs up the inside of the thigh)

- a stretching routine for both the gastroc and more importantly the soleus muscles in my calf

- a routine to release tension in my right ankle which lost a lot of its flexibility after a bad ankle sprain some years ago

- painful sessions of myofascial release with the foam roller on my itb.

- a series of pilates exercises to strengthen my core

The result;

After a month of concerted effort and a daily rehab routine, my right foot is now tracking straight and I am able to complete runs of up to 7kms with steep ascent and descent pain free. I am now going to start upping the distance with the target of a 19km/800m+ offroad race in early June.

I just thought I would share this positive story with anybody out there who is struggling with knee/itb issues at the moment. I am convinced that the majority of these issues *can* be resolved with time and commitment. Don't despair!

 

Thank you for sharing such a positive story. I am a bit down in the dumps about a lower leg/ankle pain which is still troubling me despite a few days' rest, Rice and rollering etc. I totally agree about looking at the bigger picture, like you I badly sprained this ankle some years ago, the foam roller is causing considerable pain in the soleus area and when stretching I can feel stuff going on right up in my hip/glutes. I am training for VLM and had great plans to follow a regular routine of leg strengthening exercises - squats, lunges etc - which has quickly fallen by the wayside, and what happens - injury! So your post has given me the necessary kick up the behind to get back to it and build up better leg strength to make up for my far from perfect biomechanics!

So pleased my post has helped in some way. You mention considerable pain in your soleus when you roller it. It's possible you could have done some damage to that muscle and even further up your leg when you sprained your ankle? Go easy on it, just in case. When the ankle has settled down and the pain has gone, some proprioception work (wobble board etc) will help the receptors in your ankle to start firing again properly and hopefully help to avoid another sprain in the future. Also, do some self-massage to stop the build up of scar tissue in the ankle, which can greatly inhibit mobility and flexibility if it goes too far, which is where a lot of my problem started, I think!

Good luck and have patience ..... no, that has never been my strong point either 

Thanks again for some more good advice. I never really made the connection with the ankle sprain until now. I did it a good 10 years ago going off the bottom step of our stairs, incredibly painful (second only to childbirth lol) and at the time they thought it might be broken and put me in plaster for 10 days. I've recently added some new stretches to my routine and noticed it was quite inflexible compared to the other foot. I've been doing a little bit of massage but will ramp that up a bit more as everything you are saying makes sense